What is erectile dysfunction?
According to a study conducted in the United States, 52% of men between the ages of 40 and 70 suffer from some form of erectile dysfunction. 33% of cases are mild, 48% are moderate, and 18% are severe. In Turkey, 33% of men over the age of 40 suffer from this disease, with 25.6% mild form, 5.5% moderate and 1.9% severe. It is estimated that 1 in 10 men in the world suffers from erectile dysfunction.
To what extent can the prevalence of erectile dysfunction be compared to other chronic diseases?
Erectile dysfunction is more prevalent than asthma (7%), diabetes (8%) and obesity (20%). It is as prevalent as heart diseases and high blood pressure.
Does the risk increase with age?
Erectile dysfunction becomes much more common with aging. Its prevalence is 17% in 40- to 49-year-olds, 35% in 50- to 59-year-olds, 69% in 60- to 69-year-olds, and 83% in men 70 or older. The condition is most commonly mild to moderate in younger men, with a higher proportion of severe forms in older men. In addition, the cause of erectile dysfunction is more likely to be related to psychological factors in younger men, and physical and organic factors in older men.
Why is erectile dysfunction important?
- Erectile dysfunction affects not just the man, but the couple. For example, a joint complaint mostly affects the sufferer, but with erectile dysfunction it is a problem that by definition has an effect on the couple and their relationship.
- It is part of the overall body health.
- It can lead to psychological and social problems.
- It has a negative impact on quality of life.
Do erectile dysfunction sufferers tend to seek professional help from a urologist?
Only 10% of erectile dysfunction sufferers go to a urologist. The reason for this lies in both sufferers and doctors. Reasons related to the doctor may include not being able to talk to patients about this issue, not devoting enough time to this topic because of a hectic schedule, or insufficient knowledge and experience in the issue. Patient-related reasons include not giving proper attention to the issue seen as a problem, perceiving it as a normal problem coming from age, feeling ashamed, believing there is no cure or solution, thinking the condition will heal itself, and thinking the doctor will not show empathy. Erectile dysfunction is a treatable condition. Sufferers should see a urologist who will listen to them and find a solution, preferably an andrologist expert.
What are the reasons for erectile dysfunction?
The most important factor for normal erection is healthy veins. Diseases that affect the blood vessels in the penis are among the main causes of erectile dysfunction. 90% of erectile dysfunction sufferers have a hidden organic problem. Only 10% of cases are related to psychological problems.
Which diseases most commonly cause erectile dysfunction?
Cardiovascular diseases are the most common cause (40%). Diabetes is behind 30% of cases. 10% are related to prescribed medication, 8% to surgery, 5% to nervous diseases and 3% to testosterone deficiency.
Patients suffering from diabetes are 4 times more likely to have erection problems, 3 times more likely are those with enlarged prostate, 2-3 times more likely are those with hardening of the arteries, 2 times more likely are patients with a heart disease, 1.5-2 times more likely are those with high cholesterol levels, 1.5-2 times more likely are patients with high blood pressure, and smokers are 1.5 times more likely.
Can erectile dysfunction be a signal of urgency due to other serious diseases?
It is possible for the urologist to discover undiagnosed conditions or diseases during a consultation with the patient that the patient was not aware of. Many patients are diagnosed with diabetes, high cholesterol, and blood pressure problems only after seeking help for erectile dysfunction. Cardiovascular diseases often come to light after erectile dysfunction has occurred. The appearance of erectile dysfunction could be relevant in the diagnosis, control, and treatment of specific serious diseases.
What is the relationship between diabetes and erectile dysfunction?
Erectile dysfunction is the first indication in 12% of diabetes cases. In addition, 10-15% diabetes sufferers are initially diagnosed as a result of investigations conducted by a urologist to examine erectile dysfunction. Then, these patients are referred to an endocrinology outpatient clinic.
Erectile dysfunction is present in about 70% of men with diabetes. Erectile dysfunction in diabetics is usually diagnosed earlier and is more likely to be severe (45%); therefore, treatment tends to be more difficult and the need for surgery to insert a penile prosthesis is higher in men with diabetes-related erectile dysfunction.
What is the connection between cardiovascular diseases and erectile dysfunction?
The vessels of the heart closely resemble the vessels of the penis in structure, thickness, and function. Problems in one can mean problems in the other. For example, two-thirds of men who suffer a heart attack suffer from erectile dysfunction. Furthermore, about 60% of bypass patients have erectile dysfunction. It is estimated that at least half of men who have some form of heart disease suffer from erectile dysfunction.
Consequently, those suffering from erectile dysfunction are at greater risk of cardiovascular disease. The risk of heart attack is double for them. Cardiovascular diseases occur on average 3 years after the onset of erectile dysfunction. For this reason, urology clinics generally refer patients with erectile dysfunction to cardiology departments, especially in severe cases. Similarly, cardiology departments should refer patients to urology clinics. And thus the penis is a kind of barometer for cardiac health. In other words, erectile problems are a precursor to cardiovascular diseases.
What are the stages in the diagnosis of erectile dysfunction?
The most important aspect in the diagnosis of erectile dysfunction is listening to the patient, spending enough time with him, and understanding his problem thoroughly. An assessment is made of the nature of the problem, when it occurred, what is causing it, and any links to existing chronic illnesses or medications. Smoking, exercise and eating habits are considered.
The patient is then asked specific questions as a method of measuring the condition through self-assessment. These tests are used to judge how severe the condition is, as well as for guidance regarding the likely effectiveness of various forms of treatment.
The most important stage of the diagnostic process is the physical examination. Blood pressure and body mass index are measured, and the genital area is examined. An examination of the prostate is performed. Blood tests could reveal hidden problems. Since testosterone deficiency is a significant factor in men over 40 years of age, testosterone levels are also measured.
Can a lifestyle change help with erectile dysfunction?
Sufferers of erectile dysfunction are also assessed against associated risk factors. For example, we know that smoking increases the risk by 1.5 - 2 times. Quitting smoking could therefore be significantly beneficial for all erectile dysfunction sufferers, especially those under the age of 50. Overweight and obesity are also known to be risk factors. A reduction in body mass index (i.e. weight loss) could help to overcome the problems associated with erectile dysfunction. Eating habits can lead to erectile dysfunction. A Mediterranean diet rich in fruits and vegetables, whole grains, plant proteins preferrable before animal proteins (undigested) and olive oil instead of fat is beneficial in terms of erectile dysfunction and cardiovascular diseases.
We know that a sedentary lifestyle creates vascular problems that can have a negative impact on erectile function. Men who exercise regularly are 40-60% less likely to develop erectile dysfunction than men who do not exercise. Therefore, regular exercise is a good way to prevent erectile dysfunction. It is known that brisk walking for 30-45 minutes at least 3 times a week can help to resolve the problem of erectile dysfunction.
High cholesterol creates vascular problems that can have a negative effect on erectile dysfunction. Therefore, readjusting your diet to reduce the levels of bad fats in the blood and taking cholesterol lowering medication can help in fighting erectile problems. Limiting alcohol consumption, keeping stress under control, and changing medications to drugs that do not lead to erectile problems are additional preventive measures that are good to consider.
What is the course of treatment for erectile dysfunction in Liv Hospital?
A personalized treatment plan is drawn up after careful evaluation of the patient's individual needs and expectations. In most cases, a 3-step approach is followed. In the first stage, the patient is administered oral treatment, in the second stage treatment is administered by injections into the penis, and in the third and final stage, a surgical intervention is performed.
Are medications used in the treatment of erectile dysfunction?
Yes, this is the preferred method in the first stage of treatment. Foreign patients should know that the necessary drugs for the treatment of erectile dysfunction are approved by the Turkish Ministry of Health and are in abundance. These medications have different characteristic in terms of speed of action, duration of effect and their interaction with food products. The patient and the physician make a joint decision regarding which medications to choose, how, when and for how long they should be used, and the situations in which they should not be used. Rather than simply obtaining them directly from the pharmacy, they should be taken only with a prescription and as directed by the physician, taking into account their effects and to help avoid side effects. In many countries, erectile dysfunction medications are sold without effective regulation. Patients who are unaware of what these drugs contain often suffer serious side effects. Only a qualified urologist can give you a proper recommendation on how to use these products and in what dosage.
Patients who cannot be treated with oral medication can proceed to the second step of treatment, after further testing by a urologist. In the second step, a medication is injected into the penis that aids erection. The urologist will specify what medication to use, how this treatment should be carried out and the correct dosages. The urologist will instruct the patient to make sure this is a practical form of treatment.
Under what circumstances is surgery performed as a form of treatment in Liv Hospital?
Patients who do not respond to oral or injectable treatment are suitable for surgery. Patients with penile deformity are also suitable for surgery.
How does surgery fix erectile dysfunction?
In the past, in a surgical way, one-piece cylindrical prostheses were attached to the penis. Unfortunately, these had a limited effect on the erectile function and caused problems for the patient in terms of their appearance and ease of use.
In recent years, there have been significant advances in the field of penile prostheses, along with overall advances in medical science and technology. Today, 2- and 3-piece inflatable prostheses are used. The 3-piece inflatable version is mostly preferred. Once surgically inserted, they are virtually invisible. The user can easily activate the prosthesis and achieve an erection within 5-6 seconds. Recent developments have led to an important improvement in the mechanical functions of these prostheses. This means that 80% of patients use them without any mechanical failure for ten years.
The complication that people fear most is infection. It usually leads to removal and replacement of the device. Recent use of prostheses containing an antibiotic has reduced infection rates from 10% to 1-2%. This percentage may be slightly higher for patients who are undergoing the surgery for the second time. Infection, in general, has become a far less frightening prospect for patients. Naturally, success also depends on factors such as operating room conditions, the availability of a modern ventilation system in the operating room, and the skill and experience of the surgeon.
Penile prostheses are the most effective method of treating erectile dysfunction. 85-90% of all patients are satisfied with the results of this surgery. In addition, more than 90% of patients' sexual partners are satisfied. 85% penile prosthesis patients say they would recommend it to others with a similar problem.